The Multi-Ethnic Study of Atherosclerosis (MESA) is a multicenter, cohort study in which a population-based sample of 6,814 Caucasian, Hispanic, African-American and Asian-American men and women aged 45-84 with subclinical cardiovascular disease are followed for 10 years to identify factors predictive of progression to overt cardiovascular disease. The MESA study is sponsored by NHLBI and is funded under contract. Dr. Cotch is a collaborator in the MESA-EYE component (refraction and fundus photography). The ocular component was integrated into the second MESA visit and 6235 people participated between September 2002 and December 2003. The aims of the ocular component are to document the presence and severity of retinal microvascular changes (as interpreted from digital retinal photos) indicative of macular degeneration and diabetic retinopathy, as well as to describe their interrelationships with cross-sectional and longitudinal measures of microvascular and macrovascular systemic disease as defined clinically, by imaging modality, or by analysis of biological laboratory measures. The visual acuity/objective refraction component was designed to allow us to estimate visual impairment by sex and ethnicity, determine the degree to which visual impairment could be reduced with better refractive correction, and correlate visual findings with retinal pathology. The ocular data are being cleaned in conjunction with the data coordinating center. In 2004, several manuscript proposals have been submitted and approved by the MESA study leadership. After the data become available to the study investigators (likely to occur in 2005), analysis will proceed.